Diagnosis of Gastroesophageal Reflux in Children and Adolescents

The doctor or nurse can talk with you about your child's symptoms, examine your child, and recommend tests to determine if reflux is the cause of the symptoms. These tests check the esophagus, stomach, and small intestine to see if there are any problems. However, treatment is sometimes started without tests.

The most common tests used to diagnose GER are

• Upper GI series x ray: Barium (a chalky drink) is swallowed so x rays will show the shape of the esophagus and stomach. This test can find a hiatal hernia, blockage, and other problems.
  
  
• Endoscopy: After a sedative medication is given so the patient will fall asleep, a small flexible tube with a very tiny camera is inserted through the mouth and down into the esophagus and stomach. The lining of the esophagus, stomach, and part of the small intestine is examined and biopsies (small pieces of the lining) can be painlessly obtained. The biopsies are later examined with a microscope for signs of inflammation and other problems.
  
  
• Esophageal pH probe: A thin light wire with an acid sensor at its tip is inserted through the nose into the lower part of the esophagus. The probe detects and records the amount of stomach acid coming back up into the esophagus, and can tell if acid is in the esophagus when the child has symptoms such as crying, arching the back, or coughing.

Speak with your child's health care provider if any of the following occur:
increased amounts of vomiting or persistent projectile (forceful) vomiting vomiting of fluid that is green or yellow in color or looks like coffee grounds or blood difficulty breathing after vomiting or spitting up pain related to eating, or food refusal causing weight loss or poor weight gain difficult or painful swallowing

source: http://digestive.niddk.nih.gov/ddiseases/pubs/gerinchildren/index.htm